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General Assembly Raised Bill No. 922
January Session, 2021
LCO No. 3621
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING RE VISIONS TO THE STATUTES PERTAINING
TO DISCHARGES IN A RESIDENTIAL CARE HOM E.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-535a of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective October 1, 2021): 2
(a) As used in this section: [, a "facility"] 3
(1) "Facility" means a residential care home, as defined in section 19a-4
490; 5
(2) "Emergency" means a situation in which a resident of a facility 6
presents an imminent danger to his or her own health or safety, the 7
health or safety of another resident or the health or safety of an 8
employee or the owner of the facility; 9
(3) "Department" means the Department of Public Health; and 10
(4) "Commissioner" means the Commissioner of Public Health, or the 11
commissioner's designee. 12 Raised Bill No. 922
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(b) A facility shall not transfer or discharge a resident from the facility 13
unless (1) the transfer or discharge is necessary to meet the resident's 14
welfare and the resident's welfare cannot be met in the facility, (2) the 15
transfer or discharge is appropriate because the resident's health has 16
improved sufficiently so the resident no longer needs the services 17
provided by the facility, (3) the health or safety of individuals in the 18
facility is endangered, (4) the resident has failed, after reasonable and 19
appropriate notice, to pay for a stay or a requested service [,] at the 20
facility, or (5) the facility ceases to operate. In the case of an involuntary 21
transfer or discharge, the facility shall provide written notice to the 22
resident and, if known, [his] the resident's legally liable relative, 23
guardian or conservator [shall be given a thirty-day written notification 24
which includes] at least thirty days prior to the proposed discharge date, 25
except when the facility has requested an immediate transfer or 26
discharge in accordance with subsection (e) of this section. Such notice 27
shall include the reason for the transfer or discharge, [and notice of] the 28
effective date of the discharge, the right of the resident to appeal a 29
transfer or discharge by the facility pursuant to subsection (d) of this 30
section and the resident's right to represent himself or herself or be 31
represented by legal counsel. Such notice shall be in a form and manner 32
prescribed by the commissioner, as modified from time to time, and 33
shall include the name, mailing address and telephone number of the 34
State Long-Term Care Ombudsman and be sent by facsimile o r 35
electronic communication to the Office of the Long-Term Care 36
Ombudsman on the same day as the notice is given to the resident. If 37
the facility knows the resident has, or the facility alleges that the resident 38
has, a mental illness or an intellectual disability, the notice shall also 39
include the name, mailing address and telephone number of the entity 40
designated by the Governor in accordance with section 46a-10b to serve 41
as the Connecticut protection and advocacy system. No resident shall 42
be involuntarily transferred or discharged from a facility if such transfer 43
or discharge presents imminent danger of death to the resident. 44
(c) The facility shall be responsible for assisting the resident in finding 45
[appropriate placement] an alternative residence. A discharge plan, 46 Raised Bill No. 922
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prepared by the facility, [which indicates] in a form and manner 47
prescribed by the commissioner, as modified from time to time, shall 48
include the resident's individual needs and shall [accompany the 49
patient] be submitted to the resident not later than seven days after the 50
notice of discharge is issued to the resident. The facility shall submit the 51
discharge plan to the commissioner at or before the hearing held 52
pursuant to subsection (d) of this section. 53
(d) (1) [For transfers or discharges effected on or after October 1, 1989, 54
a] A resident or [his] the resident's legally liable relative, guardian or 55
conservator who has been notified by a facility, pursuant to subsection 56
(b) of this section, that [he] the resident will be transferred or discharged 57
from the facility may appeal such transfer or discharge to the 58
Commissioner of Public Health by filing a request for a hearing with the 59
commissioner [within] not later than ten days [of] after the receipt of 60
such notice. Upon receipt of any such request, the commissioner [or his 61
designee] shall hold a hearing to determine whether the transfer or 62
discharge is being effected in accordance with this section. Such a 63
hearing shall be held [within] not later than seven business days [of] 64
after the receipt of such request. [and a determination made by the] The 65
commissioner [or his designee within] shall issue a decision not later 66
than twenty days [of the termination of] after the closing of the hearing 67
record. The hearing shall be conducted in accordance with chapter 54. 68
[(2) In an emergency the facility may request that the commissioner 69
make a determination as to the need for an immediate transfer or 70
discharge of a resident. Before making such a determination, the 71
commissioner shall notify the resident and, if known, his legally liable 72
relative, guardian or conservator. The commissioner shall issue such a 73
determination no later than seven days after receipt of the request for 74
such determination. If, as a result of such a request, the commissioner or 75
his designee determines that a failure to effect an immediate transfer or 76
discharge would endanger the health, safety or welfare of the resident 77
or other residents, the commissioner or his designee shall order the 78
immediate transfer or discharge of the resident from the facility. A 79
hearing shall be held in accordance with the requirements of 80 Raised Bill No. 922
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subdivision (1) of this subsection within seven business days of the 81
issuance of any determination issued pursuant to this subdivision. 82
(3) Any involuntary transfer or discharge shall be stayed pending a 83
determination by the commissioner or his designee. Notwithstanding 84
any provision of the general statutes, the determination of the 85
commissioner or his designee after a hearing shall be final and binding 86
upon all parties and not subject to any further appeal.] 87
(2) Any involuntary transfer or discharge that is appealed under this 88
subsection shall be stayed pending a final determination by the 89
commissioner. 90
(3) The commissioner shall send a copy of his or her decision 91
regarding a transfer or discharge to the facility, the resident and the 92
resident's legal guardian, conservator or other authorized 93
representative, if known, or the resident's legally liable relative or other 94
responsible party, and the State Long-Term Care Ombudsman. 95
(e) (1) In the case of an emergency, the facility may request that the 96
commissioner make a determination as to the need for an immediate 97
transfer or discharge of a resident by submitting a sworn affidavit 98
attesting to the basis for the emergency transfer or discharge. The facility 99
shall provide a copy of the request for an immediate transfer or 100
discharge to the resident and the notice described in subsection (b) of 101
this section. After receipt of such request, the commissioner may issue 102
an order for the immediate temporary transfer or discharge of the 103
resident from the facility. The temporary order shall remain in place 104
until a final decision is issued by the commissioner, unless earlier 105
rescinded. The commissioner shall issue the determination as to the 106
need for an immediate transfer or discharge of a resident not later than 107
seven days after receipt of the request from the facility. A hearing shall 108
be held not later than seven business days after the determination issued 109
pursuant to this section. The commissioner shall issue a decision not 110
later than twenty days after the closing of the hearing record. The 111
hearing shall be conducted in accordance with the provisions of chapter 112 Raised Bill No. 922
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54. 113
(2) The commissioner shall send a copy of his or her decision 114
regarding an emergency transfer or discharge to the facility, the resident 115
and the resident's legal guardian, conservator or other authorized 116
representative, if known, or the resident's legally liable relative or other 117
responsible party and the State Long-Term Care Ombudsman. 118
(3) If the commissioner determines, based upon the request, that an 119
emergency does not exist, the commissioner shall proceed with a 120
hearing in accordance with the provisions of subsection (d) of this 121
section. 122
(f) A facility or resident who is aggrieved by a final decision of the 123
commissioner may appeal to the Superior Court in accordance with the 124
provisions of chapter 54. Pursuant to subsection (f) of section 4-183, the 125
filing of an appeal to the Superior Court shall not, of itself, stay 126
enforcement of an agency decision. The Superior Court shall consider 127
an appeal from a decision of the commissioner pursuant to this section 128
as a privileged case in order to dispose of the case with the least possible 129
delay. 130
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2021 19a-535a
Statement of Purpose:
To allow residential care homes to qualify as home and community
based settings under the regulations of the Center for Medicare and
Medicaid Services.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]